| NPI | 1982268769 |
|---|---|
| Doing Business As | PINEVILLE ELEMENTARY SCHOOL BASED CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEANO THORNTON CEO 318-648-0375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-07-20 |